Medicaid piece of high court decision creates questions for states

Kaiser Health News: Ruling Puts Pressure On States To Act
The Supreme Court has given states a way out of expanding the Medicaid program under the health law, but governors will be under strong pressure to take the federal money that would pay for coverage for millions of low-income people (Galewitz and Werber Serafini, 6/28).

The Wall Street Journal: Medicaid Decision Looms For States
The Supreme Court's decision to let states opt out of the health overhaul's Medicaid expansion without losing current funding for the program lifts a budget mandate from states but could mean fewer Americans gain insurance coverage under the law (Burton, Radnofsky and Dooren, 6/28).

NPR: High Court Health Care Ruling Shifts Action To States
The Supreme Court's decision to uphold nearly all of the Affordable Care Act may move the debate to presidential campaign trail. But it shifts much of the burden of implementing the law to the states.
States are actually responsible for the lion's share of getting people without insurance covered under the health law (Rovner, 6/29).

Los Angeles Times: Court's Decision Could Widen Medicaid Gap
The Supreme Court did not dismantle that guarantee Thursday. But while upholding the Affordable Care Act, the court opened the door to something the president and other champions of the law sought to avoid -; widening disparities between red and blue states in who gets healthcare. Under the court's ruling, states will be free to elect not to cover all of their poor residents through their Medicaid programs (Levey, 6/29).

The New York Times: Uncertainty Over States And Medicaid Expansion
The Supreme Court said on Thursday that a huge expansion of Medicaid envisioned in the 2010 health care law was an option, not a mandate, for states. Experts disagreed on whether states would take the option, one of the most important questions created by the court's decision (6/28).

The New York Times: States Face A Challenge To Meet Health Law's Deadline
The Supreme Court's decision to uphold the Affordable Care Act shifts the focus from whether sweeping changes to the health insurance market should take place to a scramble to meet the law's rapidly approaching deadlines (Sack and Abelson, 6/28).

Bloomberg: States Confront Tough Choice on Medicaid Funds After Ruling
The U.S. Supreme Court ruling on President Barack Obama's health-care overhaul forces Republicans in states that opposed the measure to make a difficult choice. ..."There's probably a small group, at least initially, who won't do it," said Ray Scheppach, the former executive director of the National Governors Association who is now a professor of public policy at the University of Virginia in Charlottesville. "It's part political. It's part fiscal. There's pressure on them both ways" (Selway and Wayne, 6/28).

Modern Healthcare: Public Hospitals Wary Of Ruling On Medicaid
If states are not going to be required to expand Medicaid, that would hurt safety net providers, which as part of the ACA are going to see reduced payments from the disproportionate-share hospital program, Siegel said. The expansion of Medicaid would have presumably removed the need for the DSH program, but now that trade-off is put into question, he said. The [National Association of Public Hospitals and Health Systems] wants Congress to avert what it says would be a potentially disastrous outcome for vulnerable populations by immediately re-evaluating safety net funding in light of the decision, according to a news release (Barr, 6/28).

The Fiscal Times:  Will States Opt Out Of Medicaid Expansion?
Now states are facing another crossroads in the evolution of the program, assuming the Affordable Care Act, better known as Obamacare, politically survives beyond the fall elections. The Supreme Court on Thursday reaffirmed the right of states to reject expanding Medicaid to cover poor-but-working adults and prohibited the federal government from withdrawing support for other parts of the program to penalize non-participation.  Some states are already planning to ignore the coverage expansion offer when it goes into effect in 2014 (Goozner, 6/28).

CQ HealthBeat: States With Largest Uninsured Populations May Be More Likely To Opt Out Of Medicaid
Any states that choose to follow the Supreme Court's ruling and opt out of the health care law's Medicaid expansion are likely to be those with a larger population of uninsured and poor people, experts said. But doing so would mean refusing huge sums of federal money, which could be difficult for most states to do (Reichard, 6/28).

Stateline:  Court Lets States Opt Of Medicaid Expansion
But in declaring the health law constitutional, the justices also limited the federal government's power to compel states to expand their Medicaid programs. That is likely to change the course of the law's implementation in much of the country…The court ruled that if a state chooses not to participate in the Medicaid expansion, the federal government can withdraw only funds specifically targeted to the expansion. It cannot take away existing Medicaid funds (Vestal, 6/28).